Paradigm

Paradigm is a care management organization focused on complex and catastrophic medical cases. Its offerings are organized around two client-facing lines: solutions for workers with complex injuries — catastrophic care management, musculoskeletal (MSK) care management, behavioral health clinical management, case management, care at home, specialty networks and surgical cost management — and solutions covering shared decision support, an implant savings program and complex recovery management for members with unpredictable or complex diagnoses and injuries.

The company positions its model as value-based, stating that it measures and rewards clinical outcomes and holds itself to industry-standard financial and clinical metrics, with stated values centered on human-centered care, outcomes accountability, value focus and clinical expertise. Paradigm also operates a provider network that clinicians can join, and publishes case studies, webinars, position papers, insights and videos as client resources.

Business model

Paradigm contracts with organizations managing injury and healthcare claims, delivering clinical care management, care coordination and cost-management programs. Its stated value-based approach ties measurement and reward to clinical outcomes rather than activity alone, with reported results framed as return on investment for clients.

Client engagements structured around a value-based approach in which measured clinical outcomes drive the return on client investment; specific pricing or contract terms are not disclosed.

Traction

Publicly cited figures include 32% lifetime medical cost savings for catastrophic cases, 69% average savings on implantable devices, more than 1,000 clinicians in its network and more than 35 years of operation. Referenced client relationships include the University of California Office of the President and Kohl's Department Stores.